Changes in cardiometabolic risk factors, appetite-controlling hormones and cytokines after a treatment program in overweight adolescents: preliminary findings from the EVASYON study
Javier Romeo
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorDavid Martinez-Gomez
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Department of Physical Education, Sport and Human Movement, Facultad de Formación del Profesorado y Educación, Universidad Autonoma de Madrid, Madrid, Spain
Search for more papers by this authorL Esperanza Diaz
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorSonia Gómez-Martinez
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorAmelia Marti
Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorMiguel Martin-Matillas
Department of Physical Education and Sport, School of Physical Activity and Sport Sciences, University of Granada, Granada, Spain
Search for more papers by this authorM Angeles Puertollano
Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Jaén, Spain
Search for more papers by this authorOscar L Veiga
Department of Physical Education, Sport and Human Movement, Facultad de Formación del Profesorado y Educación, Universidad Autonoma de Madrid, Madrid, Spain
Search for more papers by this authorJ Alfredo Martinez
Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorJulia Wärnberg
Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
Search for more papers by this authorBelen Zapatera
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorJesus M Garagorri
Department of Pediatric, Radiology and Physical Medicine, University of Zaragoza, Spain
Search for more papers by this authorGonzalo Morandé
Servicio de Psiquiatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
Search for more papers by this authorCristina Campoy
Faculty of Medicine, University of Granada, Granada, Spain
Search for more papers by this authorLuis A Moreno
GENUD “Growth; Exercise, Nutrition and Development” Research Group, University School of Health Sciences, University of Zaragoza, Zaragoza, Spain
Search for more papers by this authorCorresponding Author
Ascension Marcos
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Ascension Marcos, PhD, Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), C/José Antonio Novais, 10 28040 Madrid, Spain.Tel: +34 915445607;fax: +34 91 5493627;e-mail: [email protected]Search for more papers by this authorEVASYON Study Group
EVASYON Study Group: Coordinator: Marcos A. Local clinical treatment teams and researchers (Principal Investigators are italics); Granada: Campoy C, López-Belmonte G, Delgado M, Martín-Matillas M, Aparicio V, Carbonell A, Agil A, Silva DR, Molina Font JA, Pérez-Ballesteros C, Piqueras MJ, Chillón P, Tercedor P, Martín-Lagos JA, Martín-Bautista E, Pérez-Expósito M, Garófano M, Aguilar MJ, Fernández-Mayorga A, Sánchez P; Madrid: Marcos A, Gómez-Martínez S, Zapatera B, Nova E, Romeo J, Díaz LE, Pozo T, Wärnberg J, Puertollano MA, Morandé G, Villaseñor A, Madruga D, Muñoz R, Veiga OL, Villagra A, Martínez-Gómez D, Garcia RM, Vaquero MP, Pérez-Granados AM, Navas-Carretero S; Pamplona: Martí A, Azcona C, Moleres A, Rendo T, Marqués M, Martínez JA; Santander: Redondo-Figuero C, García-Fuentes M, DeRufino P, González-Lamuño D, Amigo T, Lanza R, Noriega MJ; Zaragoza: Garagorri JM, Moreno LA, Romero P, De Miguel P, Rodríguez G, Bueno G, Mesana MaI, Vicente G, Fernández J, Rey-López P, Muro C, Tomás C; Data management and statistical analysis: Wärnberg J, Calle ME, Barrios L.
Search for more papers by this authorJavier Romeo
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorDavid Martinez-Gomez
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Department of Physical Education, Sport and Human Movement, Facultad de Formación del Profesorado y Educación, Universidad Autonoma de Madrid, Madrid, Spain
Search for more papers by this authorL Esperanza Diaz
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorSonia Gómez-Martinez
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorAmelia Marti
Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorMiguel Martin-Matillas
Department of Physical Education and Sport, School of Physical Activity and Sport Sciences, University of Granada, Granada, Spain
Search for more papers by this authorM Angeles Puertollano
Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Jaén, Spain
Search for more papers by this authorOscar L Veiga
Department of Physical Education, Sport and Human Movement, Facultad de Formación del Profesorado y Educación, Universidad Autonoma de Madrid, Madrid, Spain
Search for more papers by this authorJ Alfredo Martinez
Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorJulia Wärnberg
Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
Search for more papers by this authorBelen Zapatera
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Search for more papers by this authorJesus M Garagorri
Department of Pediatric, Radiology and Physical Medicine, University of Zaragoza, Spain
Search for more papers by this authorGonzalo Morandé
Servicio de Psiquiatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
Search for more papers by this authorCristina Campoy
Faculty of Medicine, University of Granada, Granada, Spain
Search for more papers by this authorLuis A Moreno
GENUD “Growth; Exercise, Nutrition and Development” Research Group, University School of Health Sciences, University of Zaragoza, Zaragoza, Spain
Search for more papers by this authorCorresponding Author
Ascension Marcos
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
Ascension Marcos, PhD, Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), C/José Antonio Novais, 10 28040 Madrid, Spain.Tel: +34 915445607;fax: +34 91 5493627;e-mail: [email protected]Search for more papers by this authorEVASYON Study Group
EVASYON Study Group: Coordinator: Marcos A. Local clinical treatment teams and researchers (Principal Investigators are italics); Granada: Campoy C, López-Belmonte G, Delgado M, Martín-Matillas M, Aparicio V, Carbonell A, Agil A, Silva DR, Molina Font JA, Pérez-Ballesteros C, Piqueras MJ, Chillón P, Tercedor P, Martín-Lagos JA, Martín-Bautista E, Pérez-Expósito M, Garófano M, Aguilar MJ, Fernández-Mayorga A, Sánchez P; Madrid: Marcos A, Gómez-Martínez S, Zapatera B, Nova E, Romeo J, Díaz LE, Pozo T, Wärnberg J, Puertollano MA, Morandé G, Villaseñor A, Madruga D, Muñoz R, Veiga OL, Villagra A, Martínez-Gómez D, Garcia RM, Vaquero MP, Pérez-Granados AM, Navas-Carretero S; Pamplona: Martí A, Azcona C, Moleres A, Rendo T, Marqués M, Martínez JA; Santander: Redondo-Figuero C, García-Fuentes M, DeRufino P, González-Lamuño D, Amigo T, Lanza R, Noriega MJ; Zaragoza: Garagorri JM, Moreno LA, Romero P, De Miguel P, Rodríguez G, Bueno G, Mesana MaI, Vicente G, Fernández J, Rey-López P, Muro C, Tomás C; Data management and statistical analysis: Wärnberg J, Calle ME, Barrios L.
Search for more papers by this authorAbstract
Romeo J, Martinez-Gomez D, Diaz LE, Gómez-Martinez S, Marti A, Martin-Matillas M, Puertollano MA, Veiga OL, Martinez JA, Wärnberg J, Zapatera B, Garagorri JM, Morandé G, Campoy C, Moreno LA, Marcos A; EVASYON Study Group. Changes in cardiometabolic risk factors, appetite-controlling hormones and cytokines after a treatment program in overweight adolescents: preliminary findings from the EVASYON study
Objective: We investigated the effects of the EVASYON program on body fatness, cardiometabolic risk factors, gut appetite-controlling hormones and serum levels of cytokines in adolescents with overweight or obesity (OW/OB).
Methods: This study comprised 13 boys (10 obese) and 12 girls (8 obese), aged 13–16 years, from a Madrid Hospital. The EVASYON program was based on a calorie-restricted diet (10–40%), increased physical activity (at least 60 min/day 5 days a week), psychological therapy and nutritional education for 13 months. Anthropometric and blood pressure measurements were measured before and after intervention. Serum glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, total peptide YY and insulin levels were determined before and after intervention. Serum levels of cytokines IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and TNF-α were also assessed before and after intervention.
Results: A decrease in body mass index (BMI), BMI z-score, skinfolds (triceps, biceps, subscapular, thigh, and calf), sum of six skinfolds and body circumferences (arm relaxed and flexed, waist, hip, and proximal thigh) values were observed after the intervention program (all p < 0.05). In addition, diastolic blood pressure also decreased (p < 0.05). A decrease in serum leptin levels (–48.4%, p < 0.001) was observed after intervention without changes in total peptide YY and insulin levels. Levels of IL-8, IL-10, and TNF-α also decreased (all p < 0.05) after the intervention program.
Conclusions: These preliminary results evidence that the EVASYON program may improve body fat, leptin, and some pro-inflammatory cytokines in adolescents with OW/OB.
References
- 1 Isomaa B, Almgren P, Tuomi T et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001: 24: 683–689.
- 2 Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006: 444: 860–867.
- 3 Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 1999: 23(Suppl 2): s2–s11.
- 4 Schwarzenberg SJ, Sinaiko AR. Obesity and inflammation in children. Paediatr Respir Rev 2006: 7: 239–246.
- 5 Wärnberg J, Nova E, Moreno LA et al. Inflammatory proteins are related to total and abdominal adiposity in a healthy adolescent population: the AVENA Study. Am J Clin Nutr 2006: 84: 505–512.
- 6 Wärnberg J, Nova E, Romeo J, Moreno LA, Sjöström M, Marcos A. Lifestyle-related determinants of inflammation in adolescence. Br J Nutr 2007: 98(Suppl 1): s116–s120.
- 7 Bastard JP, Maachi M, Lagathu C et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw 2006: 17: 4–12.
- 8 Rabe K, Lehrke M, Parhofer KG, Broedl UC. Adipokines and insulin resistance. Mol Med 2008: 14: 741–751.
- 9 Sledzińska M, Liberek A, Kamińska B. Adipokines and obesity in children and adolescents. Med Wieku Rozwoj 2009: 13: 244–251.
- 10 Antuna-Puente B, Feve B, Fellahi S, Bastard JP. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab 2008: 34: 2–11.
- 11 Martinez-Gomez D, Gomez-Martinez S, Puertollano MA et al. Design and evaluation of a treatment programme for Spanish adolescents with overweight and obesity. The EVASYON Study. BMC Public Health 2009: 9: 414.
- 12 Cole TJ, Belizzy MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000: 320: 1–6.
- 13 Moreno LA, Mesana MI, González-Gross M et al. Anthropometric body fat composition reference values in Spanish adolescents. The AVENA Study. Eur J Clin Nutr 2006: 60: 191–196.
- 14 Moreno LA, Rodríguez G, Guillén J, Rabanaque MJ, León JF, Ariño A. Anthropometric measurements in both sides of the body in the assessment of nutritional status in prepubertal children. Eur J Clin Nutr 2002: 56: 1208–1215.
- 15 Topouchian JA, El Assaad MA, Orobinskaia LV, El Feghali RN, Asmar RG. Validation of two automatic devices for self-measurement of blood pressure according to the International Protocol of the European Society of Hypertension: the Omron M6 (HEM-7001-E) and the Omron R7 (HEM 637-IT). Blood Press Monit 2006: 11: 165–171.
- 16 Wallach J. Interpretation of Diagnostic Tests, 8th edn. Philadelphia: Lippincott Williams & Wilkins, 2003.
- 17
Cohen J.
Statistical Power Analysis for the Behavioral Sciences, 2nd edn.
Hillsdale: Lawrence Erlbaum Associates, 1988.
10.1046/j.1526-4610.2001.111006343.x Google Scholar
- 18 Sudi KM, Gallistl S, Weinhandl G, Muntean W, Borkenstein MH. Relationship between plasminogen activitor inhibitor-1 antigen, leptin, and fat mass in obese children and adolescents. Metabolism 2000: 49: 890–895.
- 19 Chu NF, Wang DJ, Shieh SM, Rimm EB. Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan – The Taipei Children Heart Study. Int J Obes (Lond) 2000: 24: 1265–1271.
- 20 Elloumi M, Ben Ounis O, Makni E, Van Praagh E, Tabka Z, Lac G. Effect of individualized weight-loss programmes on adiponectin, leptin and resistin levels in obese adolescent boys. Acta Paediatr 2009: 98: 1487–1493.
- 21 Lazzer S, Vermorel M, Montaurier C, Meyer M, Boirie Y. Changes in adipocyte hormones and lipid oxidation associated with weight loss and regain in severely obese adolescents. Int J Obes (Lond) 2005: 29: 1184–1191.
- 22 Asayama K, Hayashibe H, Dobashi K et al. Decrease in serum adiponectin level due to obesity and visceral fat accumulation in children. Obes Res 2003: 11: 1072–1079.
- 23 Reinehr T, Roth C, Menke T, Andler W. Adiponectin before and after weight loss in obese children. J Clin Endocrinol Metab 2004: 89: 3790–3794.
- 24 Herder C, Schneitler S, Rathmann W et al. Low-grade inflammation, obesity, and insulin resistance in adolescents. J Clin Endocrinol Metab 2007: 92: 4569–4574.
- 25 Głowińska B, Urban M. Selected cytokines (Il-6, Il-8, Il-10, MCP-1, TNF-alpha) in children and adolescents with atherosclerosis risk factors: obesity, hypertension, diabetes. Wiad Lek 2003: 56: 109–116.
- 26 Gallistl S, Sudi KM, Aigner R, Borkenstein M. Changes in serum interleukin-6 concentrations in obese children and adolescents during a weight reduction program. Int J Obes Relat Metab Disord 2001: 25: 1640–1643.
- 27 Bastard JP, Jardel C, Bruckert E et al. Elevated levels of interleukin-6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab 2000: 85: 3338–3342.
- 28 Xydakis AM, Case CC, Jones PH et al. Adiponectin, inflammation, and the expression of the metabolic syndrome in obese individuals: the impact of rapid weight loss through caloric restriction. J Clin Endocrinol Metab 2004: 89: 2697–2703.
- 29 Reinehr T, Stoffel-Wagner B, Roth CL, Andler W. High-sensitive C-reactive protein, tumor necrosis factor alpha, and cardiovascular risk factors before and after weight loss in obese children. Metabolism 2005: 54: 1155–1161.
- 30 Xenachis C, Samojlik E, Raghuwanshi MP, Kirschner MA. Leptin, insulin and TNF-alpha in weight loss. J Endocrinol Invest 2001: 24: 865–870.
- 31 Nicoletti G, Giugliano G, Pontillo A et al. Effect of a multidisciplinaryprogram of weight reduction on endothelial functions in obese women. J Endocrinol Invest 2003: 26: rc5–rc8.
- 32 Bruun JM, Verdich C, Toubro S, Astrup A, Richelsen B. Association between measures of insulin sensitivity and circulating levels of interleukin-8, interleukin-6 and tumor necrosis factor–alpha. Effect of weight loss in obese men. Eur J Endocrinol 2003: 148: 535–542.
- 33 Monzillo LU, Hamdy O, Horton ES et al. Effect of lifestyle modification on adipokine levels in obese subjects with insulin resistance. Obes Res 2003: 11: 1048–1054.
- 34 Samuelsson L, Gottsater A, Lindgarde F. Decreasing levels of tumour necrosis factor alpha and interleukin 6 during lowering of body mass index with orlistat or placebo in obese subjects with cardiovascular risk factors. Diabetes Obes Metab 2003: 5: 195–201.
- 35 Jung SH, Park HS, Kim KS et al. Effect of weight loss on some serum cytokines in human obesity: increase in IL-10 after weight loss. J Nutr Biochem 2008: 19: 371–375.
- 36 Iannone F, Lapadula G. Obesity and inflammation – targets for OA therapy. Curr Drug Targets 2010: 11: 586–598.
- 37 Jiang X, Srinivasan SR, Webber LS, Wattigney WA, Berenson GS. Association of fasting insulin level with serum lipid and lipoprotein levels in children, adolescents, and young adults: the Bogalosa Heart Study. Arch Intern Med 1995: 23: 190–196.
- 38 Facchini FS, Hua N, Abbasi F, Reaven GM. Insulin resistance as a predictor of age-related diseases. J Clin Endocrinol Metab 2001: 86: 3574–3578.
- 39 Kiess W, Reich A, Muller G et al. Clinical aspects of obesity in childhood and adolescence – diagnosis, treatment and prevention. Int J Obes Relat Metab Disord 2001: (25 Suppl 1): s75–s79.
- 40 Ben Ounis O, Elloumi M, Ben Chiekh I et al. Effects of two-month physical-endurance and diet-restriction programmes on lipid profiles and insulin resistance in obese adolescent boys. Diabetes Metab 2008: 34: 595–600.
- 41 Reinehr T, Andler W. Changes in the atherogenic risk factor profile according to degree of weight loss. Arch Dis Child 2004: 89: 419–422.
